
<form name="editForm" role="form" novalidate ng-submit="vm.save()">

    <div class="modal-header">
        <button type="button" class="close" data-dismiss="modal" aria-hidden="true"
                ng-click="vm.clear()">&times;</button>
        <h4 class="modal-title" id="myWcIsurerLabel" data-translate="byibserverApp.wcIsurer.home.createOrEditLabel">Create or edit a Wc Isurer</h4>
    </div>
    <div class="modal-body">
        <jhi-alert-error></jhi-alert-error>
        <div class="form-group" ng-show="vm.wcIsurer.id">
            <label for="id" data-translate="global.field.id">ID</label>
            <input type="text" class="form-control" id="id" name="id"
                    ng-model="vm.wcIsurer.id" readonly />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.log" for="field_log">Log</label>
            <button class="btn btn-primary hide-input">
                选择图片
                <input type="file"  name="log" id="log" select-img="vm.wcIsurer.log" loading="vm.wcIsurer.imgLoading1" loading-success="vm.wcIsurer.imgLoadSuceess1" accept="image/jpeg,image/png,image/jpg" />
            </button>
            <div class="img-placeholder">
                <img ng-src="{{vm.wcIsurer.log}}" alt="">
                <span  ng-show="vm.wcIsurer.imgLoadSuceess1" style="color: #FE7F7F;margin-left: 10px">上传成功！</span>
            </div>
            <div class="loading-img" ng-show="vm.wcIsurer.imgLoading1"><img src="content/images/loading.gif" alt="">图片上传中...</div>
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.name" for="field_name">Name</label>
            <input type="text" class="form-control" name="name" id="field_name"
                    ng-model="vm.wcIsurer.name"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.info" for="field_info">Info</label>
            <input type="text" class="form-control" name="info" id="field_info"
                    ng-model="vm.wcIsurer.info"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.operation" for="field_operation">Operation</label>
            <input type="text" class="form-control" name="operation" id="field_operation"
                    ng-model="vm.wcIsurer.operation"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.shareholder" for="field_shareholder">Shareholder</label>
            <input type="text" class="form-control" name="shareholder" id="field_shareholder"
                    ng-model="vm.wcIsurer.shareholder"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.claims" for="field_claims">Claims</label>
            <input type="text" class="form-control" name="claims" id="field_claims"
                    ng-model="vm.wcIsurer.claims"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.phone" for="field_phone">Phone</label>
            <input type="text" class="form-control" name="phone" id="field_phone"
                    ng-model="vm.wcIsurer.phone"
                    />
        </div>
        <div class="form-group">
            <label class="control-label" data-translate="byibserverApp.wcIsurer.workTime" for="field_workTime">Work Time</label>
            <input type="text" class="form-control" name="workTime" id="field_workTime"
                    ng-model="vm.wcIsurer.workTime"
                    />
        </div>

    </div>
    <div class="modal-footer">
        <button type="button" class="btn btn-default" data-dismiss="modal" ng-click="vm.clear()">
            <span class="glyphicon glyphicon-ban-circle"></span>&nbsp;<span data-translate="entity.action.cancel">Cancel</span>
        </button>
        <button type="submit" ng-disabled="editForm.$invalid || vm.isSaving" class="btn btn-primary">
            <span class="glyphicon glyphicon-save"></span>&nbsp;<span data-translate="entity.action.save">Save</span>
        </button>
    </div>
</form>
